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This combination therapy regimen consists of the immune checkpoint inhibitor pembrolizumab, the chemotherapy agent capecitabine, and the angiogenesis inhibitor bevacizumab. It is being investigated by the University of California, San Francisco (UCSF) in a Phase II clinical trial (NCT03396926) specifically for patients with microsatellite stable (MSS) or mismatch repair proficient (pMMR) metastatic or locally advanced unresectable colorectal cancer. Pembrolizumab is a humanized monoclonal antibody that blocks the PD-1 receptor, thereby preventing its interaction with PD-L1 and PD-L2 and enhancing T-cell mediated anti-tumor activity. Capecitabine is an oral prodrug of 5-fluorouracil (5-FU) that acts as an antimetabolite, inhibiting thymidylate synthase to disrupt DNA synthesis. Bevacizumab is a monoclonal antibody that binds to vascular endothelial growth factor (VEGF), inhibiting tumor angiogenesis. The combination aims to evaluate whether the addition of pembrolizumab to standard chemotherapy and anti-VEGF therapy can improve clinical outcomes in MSS colorectal cancer patients, who typically show poor responses to immunotherapy alone.
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